Scaling-up ICT interventions in the elderly care system to reduce the risk of lonelines

Abstract

Over the past decades, the average life span of populations has increased, causing an increased prevalence of loneliness by elderly people. This leads to a lower level of well-being among the elderly population, as psychiatric- and physical disorders seem to correlate to loneliness. To deal with this, a lot of effort is put into development, research and funding of ICT interventions that aim to reduce the risk of loneliness for the elderly. However, despite these efforts, most ICT interventions are rarely used on a large scale within the elderly care system. Literature on transition theory suggests that the reason for this has to do with the stability of the societal system, making it hard for innovations to break through. In this thesis, I focus on identifying barriers and opportunities to the scaling-up of ICT interventions within the Dutch elderly care system. I demonstrate how structural, cultural and practical elements of the elderly care system, derived from system innovation theory, may form barriers or opportunities to the scaling-up of ICT interventions. Fourteen respondents responsible for different ICT interventions that aim to reduce the risk of loneliness for elderly people were interviewed. Data was gathered on how originating organizations of ICT interventions perceive the process of scaling-up their ICT intervention, how they aim to realize scaling-up and how they are constrained or enabled. From the findings, the need for medical validation of interventions, costs of interventions, a long decision period by provider organizations and the un- or misuse of acquired interventions are identified as main barriers. Through interpretive analysis and insights derived from system innovation theory, several underlying structural, cultural and practical barriers are derived. In addition, opportunities that become apparent from the findings are put in perspective with the identified barriers and the underlying structural, cultural and practical elements of the system. Theoretically, this thesis shows that taking a Multi-Level Perspective and distinguishing between structural, cultural and practical elements of the system can be of added value to analyze barriers and opportunities of transitions in complex socio-technical systems. The insights of this thesis may help policy makers and originating organizations to address problems in scaling-up, in order to make use of the potential that ICT interventions may have in reducing the risk of loneliness for the elderly.